ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: SA-OR35

Comprehensive Evaluation of CKD Heat Map

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Grams, Morgan, CKD Prognosis Consortium, Baltimore, Maryland, United States
  • Gansevoort, Ron T., CKD Prognosis Consortium, Baltimore, Maryland, United States

Group or Team Name

  • CKD Prognosis Consortium.

The 2012 KDIGO heat map framework for CKD analyzed five outcomes in 1.2 million participants. We comprehensively evaluated this framework using new equations for eGFR using creatinine alone and in combination with cystatin C (eGFRcr and eGFRcr-cys; CKD-EPI 2021 and EKFC) and more categories of albuminuria, assessing their individual and combined associations with ten adverse outcomes, overall and by age, sex, diabetes, and cardiovascular disease.


Individual-level data analysis: 27,503,140 participants from 114 global cohorts (eGFRcr); 720,736 participants from 20 cohorts (eGFRcr-cys). Outcomes: kidney failure with replacement therapy, all-cause mortality, cardiovascular mortality, acute kidney injury, hospitalization, coronary heart disease, stroke, heart failure, atrial fibrillation, and peripheral artery disease.


Mean participant eGFRcr was 90 ml/min/1.73 m2 (SD, 22) and median ACR was 11 mg/g (interquartile range 8-16 mg/g). Lower eGFRcr and higher ACR were associated with higher risk of all ten adverse outcomes, including in the mildest categories of CKD (eGFR 45-59 ml/min/1.73 m2 and ACR <30 mg/g, or ACR 30-299 mg/g) and within subgroups. Associations were generally stronger and with less U-shape in the higher range of eGFR for eGFRcr-cys compared with eGFRcr.


This comprehensive evaluation of the heatmap framework in >27 million people demonstrated that the framework holds for associations with previous endpoints as well as novel kidney and cardiovascular endpoints; across subgroups of age, sex, diabetes, and cardiovascular disease; and for different GFR equations, including those incorporating cystatin C.


  • NIDDK Support